Facility Evaluation Report

On 04/16/2024 at 3PM, Licensing Program Analyst (LPA) D Panlilio conducted an unannounced Case Management visit to conduct a Health & Safety Check on the residents. LPA met with staff (S1) and spoke to Administrator (ADM) on the phone who authorized S1 to act on his behalf and sign the reports. LPA explained the purpose of the visit with staff (ADM, S1).

During the health and safety check, LPA observed a total of 2 staff and 4 residents at the facility. LPA toured facility including but not limited to bedrooms, kitchen, bathroom, and common areas. Residents in care appear to be safe and there are no imminent health/safety concerns on today's date. LPA spoke with staff (S2) on the phone who confirmed that on 04/09/24 he mishandled resident's (R1) information when he wrote down R1's incident information on his personal DMV paperwork during a visit by an IB investigator.

· Failure of staff to safeguard confidentiality of resident's (R1) records

Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties.

Exit interview conducted. A copy of appeal rights and this report was provided.